NPI | 1528451812 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: TX PA09643) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA PA54434) |
Enumeration Date | 2015-03-10 |
Last Update Date | 2018-04-18 |